Expert consensus on odontogenic maxillary sinusitis multi-disciplinary treatment

Odontogenic maxillary sinusitis (OMS) is a subtype of maxillary sinusitis (MS). It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion. Due to the lack of unique clinical features, OMS is difficult to distinguish from other types of rhinosinusitis. Besides, the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis. Its current diagnosis and treatment are thus facing great difficulties. The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS. However, this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality. Based on systematically reviewed literature and practical experiences of expert members, our consensus focuses on characteristics, symptoms, classification and diagnosis of OMS, and further put forward multidisciplinary treatment decisions for OMS, as well as the common treatment complications and relative managements. This consensus aims to increase attention to OMS, and optimize the clinical diagnosis and decision-making of OMS, which finally provides evidence-based options for OMS clinical management.

Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy

BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.

Evaluation of the Effectiveness and Safety of One-Time Endodontics in the Treatment of Chronic Apical Periodontitis with Sinus Tract in Pediatric Deciduous Teeth

Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.

罕见抗-Di^(b)致严重胎儿新生儿溶血病的实验室检测与相关研究

目的对1例高频抗体导致的胎儿新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)进行检测、鉴定及配血。方法对患儿进行新生儿溶血试验,对母亲进行血清学意外抗体鉴定,并对母亲红细胞进行常见高频抗原鉴定;对检出抗体进行IgG分型检测,并用流式细胞术进行单核细胞体外吞噬致敏红细胞试验,以检测抗体相关的吞噬率;对患儿母亲、父亲及舅舅进行相关红细胞血型基因测序;利用稀释的母亲血浆和抗人球卡法,在献血者中进行大规模相合血液的筛选。结果产妇鉴定为Di(b-)稀有血型,产生了抗-Di b(效价512)并导致了严重的HDFN;抗-Di b亚型分型为IgG1和IgG2型,单核细胞体外吞噬效率为88.83%(74.7/84.09);产妇亲属中没有相合献血者,后续从5520名献血者中筛选到2例Di(b-)相合血液,患儿接收输血治疗后康复出院。后续在51334名献血者中筛查到17名Di(b-)献血者,该数据表明Di(b-)在广州地区献血者中的分布频率约为三千分之一(0.033%,17/51334)。结论综合利用血型血清学及分子生物学方法诊断了抗-Di b所致的严重HDFN,建立了1种有效大规模筛查Di(b-)稀有血型的方法并找到相合血液,为建立Di(b-)稀有血型库奠定了基础。

4DI110型空压机的技术改造与操作优化

文章通过介绍新引进的4DI110型离心式空压机(以下简称“空压机”)试运行阶段开始以来的运行情况和气温变化对空压机出口流量造成的影响,分析空压机出口流量随气温变化而变化的规律,指出空压机防喘阀V3004阀不能自动调节出口压力,影响空分装置工况的稳定。为实现空压机出口压力的稳定,对其防喘阀V3004阀采取增设自动旁路阀V3008阀的技术改造,同时优化和完善相关逻辑控制并阐述了空压机经技术改造后的操作优化和取得的实际效果。

Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps

Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

Relationship between dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor and paranasal sinusitis

AIM：To determine the clinical features of the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor and its relationship with paranasal sinusitis.· METHODS：A retrospective analysis of 46 patients who received surgical treatment at the Department of Ophthalmology,Beijing Tongren Hospital,Capital Medical University for the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor from October 2010 to December 2012.Each patient underwent magnetic resonance imaging（MRI） of the orbits and the 4paranasal sinuses.Disease status and the level of serum immunoglobulin G4（IgG4） was measured before and6 mo after surgery.· RESULTS：The initial clinical feature of the idiopathic dacryoadenitis type of orbital inflammatory pseudotumor was redness or swelling of the eyelids.Masses were palpated in the area of the lacrimal gland in some patients.Of the 46 patients,16 also suffered from sinusitis（34.8%）,with 14 cases of ethmoid sinusitis,8cases of maxillary sinusitis,9 cases of sphenoid sinusitis,and 8 cases of frontal sinusitis.Of the 16 patients with sinusitis,4 patients had a medical history of rhinitis（range：10mo to 15 y previously）,10 patients had occasional nasal congestion,and 2 patients had no nasal congestion.Thirteen of the 46 patients had elevated serum IgG4 levels.Nine of these 13 patients had MRI signs of sinusitis.All patients（n=46） received oral glucocorticoid treatment for approximately 3mo after surgery.No sign of recurrence was found in the orbital MRI 6mo after surgery.Of the 16 patients with sinusitis,9cases of elevated serum IgG4 levels improved after treatment with decreased serum IgG4 level and 7 cases of normal serum IgG4 levels remained unchanged.· CONCLUSION：Some patients with the dacryoadenitis subtype of idiopathic orbital inflammatory pseudotumor may also suffer from paranasal sinusitis.The incidence of paranasal sinusitis was much higher in patients with IgG4-elevated dacryoadenitis subtype orbital inflammatory pseudotumor than in those with normal IgG4 levels.Dacryoadenitis subtype orbital inflammatory pseudotumor and paranasal sinusitis may both the clinical manifestations of IgG4-related disease involved in different locations.

Socioeconomic Status Impacts the Prognosis of Chronic Rhinosinusitis Treated by Endoscopic Sinus Surgery:An Observational Cohort Study in Northeast China

Objective To explore the association between socioeconomic status(SES)and postoperative outcomes in patients with chronic sinusitis(CRS)after functional endoscopic sinus surgery(ESS).Methods We conducted an observational cohort study of 1,047 patients with CRS undergoing ESS.Discharged patients were followed up to 72 weeks for all-cause recurrence events.Baseline SES was established based on occupation,education level,and family income of the patients 1 year before the operation.Kaplan–Meier method was used to calculate the recovery rate after ESS,and Cox proportional hazards regression analysis was used to evaluate the relationship between SES and prognosis.Results Patients of middle SES had lower unadjusted all-cause recurrence than those of low or high SES;24-week overall recovery rate was 90.4%[95%confidence interval(CI):89.6%–91.2%]in patients of middle SES,13.5%(95%CI:12.8%–14.2%)in patients of low SES,and 31.7%(95%CI:30.7%–32.7%)in patients of high SES(both log-rank P<0.001).After adjustment for covariates,hazard ratios(HRs)were7.69(95%CI:6.17–9.71,Ptrend<0.001)for all-cause recurrence for low SES versus middle SES,and 6.19(95%CI:4.78–7.93,Ptrend<0.001)for middle SES versus high SES.Conclusion Low SES and high SES were more associated with the worse prognosis of CRS patients after ESS than middle SES.

Relationship between chronic rhinosinusitis and lower airway diseases: An extensive review

Significant links between allergic rhinitis and asthma have been reported, and the united airway disease hypothesis is supported by numerous findings in epidemiologic, physiologic, pathologic, and immunologic studies. The impact of allergic rhinitis on asthma has been established. On the other hand, the relationship between chronic rhinosinusitis and lung diseases has been under investigation. Chronic rhinosinusitis is a common disease, and the high prevalence of chronic rhinosinusitis in some kinds of lung diseases has been reported. Recent studies suggest that the treatment of chronic rhinosinusitis has beneficial effects in the management of asthma. Here, we present an overview of the current research on the relationship between chronic rhinosinusitis and lower airway diseases including asthma, chronic obstructive pulmonary disease, cystic fibrosis, diffuse panbronchiolitis, primary ciliary dyskinesia, idiopathic bronchiectasis, and allergic bronchopulmonary aspergillosis.

借助DIS实验突破教学难点——以“磁场对通电导线的作用力”为例

教材中直接得出安培力的公式,该知识点难度较大,传统实验现象不够明显且只能定性探究,学生无法真正理解该物理规律和公式。传统实验加DIS实验可对物理规律进行定性和定量的探究,有利于学生物理学科核心素养的培养。

用DIS电磁定位魔板探究平抛运动的教学设计

随着数字化信息系统在中学物理教学中的逐步融入,我国中学物理实验呈现智能化、现代化的发展趋势.以DIS电磁定位魔板为实验装置,通过科学探究的关键环节,设计探究平抛运动的教学流程.实践发现传感器实验也适合做科学探究,能够充分提升学生科学探究和推理论证的能力.

Correlation between Radiological Staging of Chronic Rhinosinusitis and Revision of Endoscopic Sinus Surgery

Introduction: Chronic rhinosinusitis (CRS) is an inflammatory condition affecting the sinonasal mucosa with duration of more than 12 weeks. Multifactorial aetiology contributes to its refractoriness. Functional endoscopic sinus surgery (FESS) is the most common surgical technique preferred in CRS not responding to medical management, showing high success rates. However, some failure has been noted, requiring revision FESS. CT (Computed Tomography) is a diagnostic tool for CRS, and aids in improving surgical outcomes. Combined with the Lund-Mackay scoring system, CT can help stage the CRS, predicting the need for revision surgery. Methods: In our paper, we aimed to study the relationship between severity of CRS using radiological staging and revision of functional endoscopic sinus surgery, assessing outcome after at least 1 year of follow-up. There was a single centre retrospective study involving 150 patients selected by random sampling, to study the correlation between the severity of chronic rhinosinusitis and revision of functional endoscopic sinus surgery (FESS). The study was conducted in the ENT department of King Hamad University Hospital, Bahrain for a time period of 6 months. Records were scanned and scored using Lund-Mackay system. Lund Mackay score of 10 and above was considered severe. The relation between increased severity with Lund Mackay score on the CT scan and the need for revision sinus surgeries was then determined. Results and Conclusion: This study concludes that LMS score in CT scans can be used to predict the outcomes of primary FESS procedure and the need for revision surgery in the management of CRS.

嗜热链球菌c-di-AMP合成酶的结构预测

作为一种新兴第二信使分子,c-di-AMP具有全局调控胞内渗透压平衡、DNA损伤和生物膜形成等生理功能。本实验室在实验前期筛选出了一株高产胞外多糖的嗜热链球菌菌株S-3,但未对其进行c-di-AMP信号通路研究。本研究在嗜热链球菌S-3全基因组中筛选出c-di-AMP合成酶(StDAC),对其二级结构进行预测,结果显示St DAC二级结构包含42.98%α-螺旋、15.32%β-折叠和38.30%无规则卷曲。利用SWISS-MODEL和Modeller对StDAC进行单模板和多模板同源建模,由SWISS-MODEL建立的模型通过了Ramachandran、Errat和Verify-3D评估,表明其结构较为合理;而Modeller建立的模型仅通过了Ramachandran评估,总体结构评分较低。本研究预测的嗜热链球菌StDAC三维模型为解析其结构和功能奠定了基础。

乳酸菌第二信使分子c-di-AMP研究进展

微生物依赖信号识别和信号传递来感知并响应外界环境变化。c-di-AMP作为第二信使分子在信号传导过程中发挥着关键作用,其通过酶、转录调控因子和核糖开关等受体靶标来调控细胞生长、生物膜形成、K^(+)稳态、DNA完整性、细胞壁合成和脂肪酸合成等与生理功能相关的基因和蛋白的表达。尽管对于c-di-AMP代谢调控在枯草芽孢杆菌、单增李斯特氏菌和金黄色葡萄球菌等细菌中的研究较为深入,但对其在乳酸菌中的研究却相对较少。基于此,文章重点关注乳酸菌中cdi-AMP的代谢及其在K^(+)稳态和抑制甘氨酸甜菜碱转运中的信号传导作用;同时,通过总结现有研究中的乳酸菌c-di-AMP代谢调控,深化对乳酸菌第二信使分子信号调控的认知。

Study on the Impact of Cognitive Nursing Model on Postoperative Quality of Life in Patients Undergoing Chronic Sinusitis Surgery

Objective:To explore effective nursing programs for surgical patients with chronic sinusitis(CS).Methods:62 CS surgery patients were randomly divided into a research group and a control group with 31 cases in each group.The patients in the research group received cognitive nursing care,while the patients in the control group received routine nursing care.The nursing effects of the two groups were compared.Results:The postoperative quality-of-life scores,health behavior scores,complication rates,and nursing satisfaction scores of the patients in the research group were all better than those of the control group(P<0.05).Conclusion:The cognitive nursing model significantly improves the condition of CS surgery patients,thus it should be popularized.

Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Use of MLC901 in cerebral venous sinus thrombosis:Three case reports

BACKGROUND Cerebral venous sinus thrombosis(CVT)is rare cause of cerebrovascular disease.The incidence is 0.5%of all stroke.The majority of affected patients are young adults(mean age:35-40 years)with mild to moderate disabilities.Poor outcome with severe disability is seen in 13%of cases.Early diagnosis and treatment are important for good outcomes and preventing complications.Treatment options are limited and mostly based on consensus.NeuroAiD II™(MLC901;Moleac Pte,Ltd,Singapore)has a potential beneficial role in post-stroke recovery,by aiding the natural brain recovery process.CASE SUMMARY MLC901 consists of nine natural herbal ingredients.Studies have shown its safety profile and aid in post stroke recovery.The aim of this case series was to demonstrate the potential role of MLC901 in stroke recovery of patients with cerebral venous sinus thrombosis(CVST)who received MLC901 in addition to standard of care.The prescribed dose of MLC901 is 400 mg/cap two capsules,three times a day.Data from these patients were prospectively collected at baseline and at monthly visits,for a duration of 3 mo.Outcome measures included adherence to therapy,side effects,National Institutes of Health Stroke Scale,Glasgow Coma Scale,modified Rankin Scale,and the Short Orientation-Memory-Concentration Test.MLC901 was well tolerated and no side effects were reported.All patients were stable with improved condition.CONCLUSION This case series highlights the potential therapeutic effects of MLC901 on CVST and provides support for further studies.

Sinonasal teratocarcinosarcoma involving the nasal cavity,unilateral paranasal sinuses,and intracranial invasion:A case report

BACKGROUND Sinonasal teratocarcinosarcoma(SNTCS)is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses.Typically,it exhibits an invasive behavior towards adjacent structures;however,in exceptional instances,it may infiltrate the intracranial compartment.Due to the tumor's rarity and lack of distinctive features on computed tomography(CT)and magnetic resonance imaging(MRI)images,SNTCS is often misdiagnosed.CASE SUMMARY In this study,we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission.CT and MRI scans revealed the presence of a mass in the right nasal cavity,with lesions extending to the right ethmoid sinus and right frontal region.Subsequently,the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor.The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS.CONCLUSION SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses,presenting a diagnostic challenge due to its nonspecific imaging findings.MRI accurately delineates the location,morphological characteristics,size,internal structure,extent of surrounding involvement,and metabolic information of the lesion.These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS.Nevertheless,a definitive diagnosis still requires a pathological biopsy.

城轨交通DI型弹条接触疲劳断裂机理研究

以DI型弹条为研究对象,基于实验得到正常行车状态下弹条的频域特性,采用有限元仿真对弹条进行失效特性分析。研究表明,弹条的断裂为疲劳断裂,表面缺陷产生的应力集中是弹条发生疲劳断裂的主要原因;在正常行车条件下,弹条和钢轨均在360 Hz和700 Hz附近产生峰值,其中钢轨的垂向及横向振动频谱变化趋势基本一致;弹条安装深度过大将导致弹条与铁垫板接触点产生一定应力集中,在长期强迫振动激励作用下弹条容易发生疲劳折断。

Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation:A case report

BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.